Field of the Disclosure
The structures and methods of the present invention will significantly facilitate the severing and removal of tissues from internal surgical sites during both minimally invasive and traditional open surgical procedures. These methods and structures are particularly well adapted, however, for laparoscopic procedures requiring removal of significant masses of tissues, such as for removal of a large fibroid or cancerous tissue, using a morcellation device.
Background
Minimally invasive surgical procedures, such as laparoscopic and robotic surgery procedures, often require the removal large masses of tissue. For example a surgeon may need to remove a uterine fibroid or a large cancerous mass from the peritoneal cavity without making a large incision into the patient. Morcellators assist surgeons in severing and removing large tissue masses from the patient in minimally invasive surgery.
Conventionally, a morcellator includes a rotating cylindrical inner tube having a sharp distal cutting edge, which rotates within a stationary outer tube. The morcellator is inserted into the patient through a cannula or trocar, or directly through an incision. Access and optical visualization of such tissue removal procedures is generally facilitated by pneumo-peritoneum (gas insufflation), and by positioning of an endoscope, laparoscope, or the like, within the distended body cavity.
A surgeon inserts the grasping instrument (i.e., tenaculum) through the cylindrical tube, grasps the tissue for morcellation, and pulls the tissue through the inside lumen of the tube. When the grasper or tenaculum pulls the tissue through the tube, the tissue is positioned adjacent to the cutting edge or circumference of the tube, which cuts, severs, or morcellates the tissue. By repeating the grasping and severing procedure, the surgeon can remove the large tissue mass incrementally.
FIGS. 1A-1C depict a conventional hand-held morcellator 100 intended to divide and remove large masses of tissue during surgery. FIG. 1A shows a morcellator 100 inserted into a peritoneal cavity 102 of a patient 103. Tissue mass 190 is removed from cavity 102 by grasping and pulling tissue mass 190 through morcellator's inner tube 110 using a grasper or tenaculum (hereinafter “tenaculum 160”). The distal end of inner tube 110 contains a cutting edge, which is operated by a motor. By positioning tissue mass 190 in contract with a cutting edge and pulling morcellated tissue mass 190 through inner tube 110, tissue mass 190 is cut, retrieved and removed from the patient.
FIGS. 1B-1C show another prior art morcellator 100. FIG. 1B shows an outer tube 130 having a distal end 131 in contact with tissue mass 190. FIG. 1C shows the outer tube 130 encasing an inner tube 110, wherein a surgeon inserts a grasper or tenaculum 160 to pull and cut the tissue mass 190.
In this prior art device, a morcellator includes a cylindrical inner lumen, driving shaft or tube (hereinafter “inner tube 110”). Inner tube 110 has a sharp distal cutting edge, which rotates within a stationary outer tube 130. A motor conventionally positioned in a proximal portion of the morcellator, for example in handle 200, powers rotation of the cutting edge.
After the organ or tissue mass 190 has been severed from the patient, a morcellator is inserted into a patient through a cannula or trocar, or directly through an incision. A surgeon inserts a grasping instrument (i.e., tenaculum 160) through inner tube 110, grasps tissue mass 190, for morcellation, and pulls the tissue mass 190 through the inside lumen of inner tube 110. When tissue mass 190 is positioned adjacent to cutting edge 120 or circumference of inner tube 110, cutting edge 120 cuts, severs, or morcellates the tissue. By repeating the severing and grasping procedure, a surgeon removes tissue mass 190 incrementally.
Corresponding reference characters indicate corresponding components throughout the several views of the drawings. Skilled artisans will appreciate that elements in the figures are illustrated for simplicity and clarity and have not necessarily been drawn to scale. For example, the dimensions of some of the elements in the figures may be exaggerated relative to other elements to help to improve understanding of various embodiments of the present disclosure. Also, common but well-understood elements that are useful or necessary in a commercially feasible embodiment are often not depicted in order to facilitate a less obstructed view of these various embodiments of the present disclosure.